chrisvoncsefalvay/vaers-narrative-generation huggingface dataset:
Age: 80.0
Sex: F
Vaccine: COVID19
Symptoms: Mental status changes, Nephrolithiasis, Neurological decompensation, Renal cyst, SARS-CoV-2 test positive
Clinical narrative: Hospital Course:       Patient is a 82-year-old female with a previous history of severe dementia who was admitted via EMS, patient without ability to give significant history, per family she has stopped walking and had stopped eating or drinking and that they were concerned he could no longer take care of her at home.  In patient with history of underlying dementia, she was admitted to the hospitalist service.  His CT was negative for acute CVA, during this admission patient was diagnosed with metabolic encephalopathy superimposed on severe underlying dementia.  The patient was severe debility info to thrive, palliative Care was involved but family declined from hospice requested PEG tube.  Peg tube was placed, patient also tested positive for COVID, she tested positive on/7, respiratory symptoms resolve 7/14.  Patient was still positive may discharge.  On the day discharge, patient still with waxing waning encephalopathy, debility failure to thrive.  Patient is currently a full code, concerned that patient is having worsening clinical decompensation secondary to her severe dementia and is more appropriate for end of life care, however family has  Refused.  Patient had PEG tube placed 7/10, currently on tube feeds, discharged to skilled nursing facility.     Altered mental statu -Acute metabolic encephalopathy - progressive weakness/ debility + poor po intake x 3 days, after exposure to Covid; covid positive on admission. CT head no stroke/bleed.  UA unremarkable.  Ammonia wnl. prob 2 to acute Covid infection on top of underlying dementia. Improved some but far from baseline.   Debility, failure to thrive - palliative involved - family declined referral to hospice for end of life care, requested PEG. Perc GJ tube placed on 7/10 - TF via J tube, meds via G tube.    COVID-19 infection - +cough but not SOB. CXR u/r. Mucinex. No hypoxia, no indication for steroids or remdesivir at this time. Sxs noted 7/5. Tested positive 7/7. Resp sxs resolved 7/14. Repeat covid pcr 7/17 POSITIVE (prob Day 11-12   Dementia - chronic, prob Alzheimer's. Also HOH. Worsening even before acute illness. PT/OT if tolerated. Resume memantine/ donepezil (Home med   Ess HTN - unable to take meds. Home meds per G tube. BP now w/in acceptable limits.    Patient is a FULL CODE     Significant Diagnostic Studies:    Ct Abdomen and Pelvis: Nonobstructing renal stones.   Left renal cyst.   The stomach is not well distended.   Other findings as detailed above.         Procedure(s):  Placement of 18 Fr x 45 cm percutaneous gastrojejunostomy tube (Perc GJ) under fluoroscopic guidance. 7/9/2022
Age: 80.0
Sex: F
Vaccine: COVID19
Symptoms: Toxic encephalopathy, Urine analysis normal
Clinical narrative: Hospital Course:       Patient is a 82-year-old female with a previous history of severe dementia who was admitted via EMS, patient without ability to give significant history, per family she has stopped walking and had stopped eating or drinking and that they were concerned he could no longer take care of her at home.  In patient with history of underlying dementia, she was admitted to the hospitalist service.  His CT was negative for acute CVA, during this admission patient was diagnosed with metabolic encephalopathy superimposed on severe underlying dementia.  The patient was severe debility info to thrive, palliative Care was involved but family declined from hospice requested PEG tube.  Peg tube was placed, patient also tested positive for COVID, she tested positive on/7, respiratory symptoms resolve 7/14.  Patient was still positive may discharge.  On the day discharge, patient still with waxing waning encephalopathy, debility failure to thrive.  Patient is currently a full code, concerned that patient is having worsening clinical decompensation secondary to her severe dementia and is more appropriate for end of life care, however family has  Refused.  Patient had PEG tube placed 7/10, currently on tube feeds, discharged to skilled nursing facility.     Altered mental statu -Acute metabolic encephalopathy - progressive weakness/ debility + poor po intake x 3 days, after exposure to Covid; covid positive on admission. CT head no stroke/bleed.  UA unremarkable.  Ammonia wnl. prob 2 to acute Covid infection on top of underlying dementia. Improved some but far from baseline.   Debility, failure to thrive - palliative involved - family declined referral to hospice for end of life care, requested PEG. Perc GJ tube placed on 7/10 - TF via J tube, meds via G tube.    COVID-19 infection - +cough but not SOB. CXR u/r. Mucinex. No hypoxia, no indication for steroids or remdesivir at this time. Sxs noted 7/5. Tested positive 7/7. Resp sxs resolved 7/14. Repeat covid pcr 7/17 POSITIVE (prob Day 11-12   Dementia - chronic, prob Alzheimer's. Also HOH. Worsening even before acute illness. PT/OT if tolerated. Resume memantine/ donepezil (Home med   Ess HTN - unable to take meds. Home meds per G tube. BP now w/in acceptable limits.    Patient is a FULL CODE     Significant Diagnostic Studies:    Ct Abdomen and Pelvis: Nonobstructing renal stones.   Left renal cyst.   The stomach is not well distended.   Other findings as detailed above.         Procedure(s):  Placement of 18 Fr x 45 cm percutaneous gastrojejunostomy tube (Perc GJ) under fluoroscopic guidance. 7/9/2022
Age: 66.0
Sex: M
Vaccine: COVID19
Symptoms: Expired product administered, No adverse event
Clinical narrative: vaccine was expired, no temperature excursions occurred and moderna determined the vial "maintained the activity necessary to protect against the SARS CoV-2 virus at the time of administration".  Patient reported no adverse reactions.
Age: 77.0
Sex: F
Vaccine: COVID19
Symptoms: Biopsy skin abnormal, Full blood count normal, Lichen planus, Metabolic function test, Pruritus
Clinical narrative: In March or April of 2022, I started getting purple raised bumps on my legs that had a white, crusty area to them and they itched like crazy. They spread all over my legs. I went to see my dermatologist who did a biopsy of the lesions on my leg where they found lichen planus. They put me on a month of a decreasing dose of a steroid and prescribed a topical ointment. They informed me that it could a year or two to fully resolve and I should only need to be seen again if things get significantly worse.
Age: 77.0
Sex: F
Vaccine: COVID19
Symptoms: Rash, Scab, Skin discolouration
Clinical narrative: In March or April of 2022, I started getting purple raised bumps on my legs that had a white, crusty area to them and they itched like crazy. They spread all over my legs. I went to see my dermatologist who did a biopsy of the lesions on my leg where they found lichen planus. They put me on a month of a decreasing dose of a steroid and prescribed a topical ointment. They informed me that it could a year or two to fully resolve and I should only need to be seen again if things get significantly worse.
Age: 28.0
Sex: F
Vaccine: COVID19
Symptoms: Drug ineffective, Expired product administered
Clinical narrative: Expired vaccine. No temperature excursion occurred. Moderna determined vial "maintained the activity necessary to protect against the SARS CoV-2 virus at the time of administration." No adverse event reported.
Age: 67.0
Sex: F
Vaccine: COVID19
Symptoms: Anticoagulant therapy, COVID-19, Chest pain, Computerised tomogram thorax normal, Cough
Clinical narrative: Physician Discharge Summary     Patient: MRN: Age:67 y.o. DOB: Admit Date:  7/7/2022 Discharge Date:  7/11/2022      Principal Diagnoses:  Principal Problem:   Precordial pain Active Problems:   Morbid obesity   COVID-19 virus detected     Discharge Diagnosis: Precordial chest pain   Hospital Course: Patient is a 67 y.o.  Female who is seen at local ED for concern of chest pain.  Reports that she had a CT at a hospital two days ago and was diagnosed w/ PE and was placed on Eliquis but has not take any today because she has lost it.  Reports that pain is substernal, and is worse with movement.    Precordial chest pain. Cardiology evaluated the patient. The chest pain was deemed to be secondary to pleuritic in origin. CT with no PE.  Echocardiogram with ejection fraction 50-55% with no motion abnormalities. Will continue on NSAIDS when necessary. Patient was informed that chest pain is Pleuritic and will take a few weeks before it completely resolves.   COVID 19 viral infection.  Patient tested positive on 7/7/2020. Patient had cough, fatigue, tiredness and chest pain; all resolving Patient received Remdesivir, steroids. Both discontinued due to improvement continue with Ascorbic acid and Zinc   History of paroxysmal A. fib. Continue Eliquis rate controlled.   Patient was examined in her bed today. She was calm and not in distress. She states she feels much better except for cough. She is not on supplemental oxygen and passed ambulatory saturation. She will be discharged today with cough medicine and instructions to follow up with her PCP within 3-5 days. She requested CPAP machine and was advised to discussed that with her PCP, as she will need a sleep study for qualification. She states he chest pain is improving. She is to observe COVID restrictions and use a mask after discharge.   Consults to: Cardiology      Significant Diagnostic Studies: TTE, CT Chest   Procedure(s): n/a   Disposition: Home   Discharge Condition: Stable
Age: 67.0
Sex: F
Vaccine: COVID19
Symptoms: Echocardiogram normal, Fatigue, Pain, Pleuritic pain, SARS-CoV-2 test positive
Clinical narrative: Physician Discharge Summary     Patient: MRN: Age:67 y.o. DOB: Admit Date:  7/7/2022 Discharge Date:  7/11/2022      Principal Diagnoses:  Principal Problem:   Precordial pain Active Problems:   Morbid obesity   COVID-19 virus detected     Discharge Diagnosis: Precordial chest pain   Hospital Course: Patient is a 67 y.o.  Female who is seen at local ED for concern of chest pain.  Reports that she had a CT at a hospital two days ago and was diagnosed w/ PE and was placed on Eliquis but has not take any today because she has lost it.  Reports that pain is substernal, and is worse with movement.    Precordial chest pain. Cardiology evaluated the patient. The chest pain was deemed to be secondary to pleuritic in origin. CT with no PE.  Echocardiogram with ejection fraction 50-55% with no motion abnormalities. Will continue on NSAIDS when necessary. Patient was informed that chest pain is Pleuritic and will take a few weeks before it completely resolves.   COVID 19 viral infection.  Patient tested positive on 7/7/2020. Patient had cough, fatigue, tiredness and chest pain; all resolving Patient received Remdesivir, steroids. Both discontinued due to improvement continue with Ascorbic acid and Zinc   History of paroxysmal A. fib. Continue Eliquis rate controlled.   Patient was examined in her bed today. She was calm and not in distress. She states she feels much better except for cough. She is not on supplemental oxygen and passed ambulatory saturation. She will be discharged today with cough medicine and instructions to follow up with her PCP within 3-5 days. She requested CPAP machine and was advised to discussed that with her PCP, as she will need a sleep study for qualification. She states he chest pain is improving. She is to observe COVID restrictions and use a mask after discharge.   Consults to: Cardiology      Significant Diagnostic Studies: TTE, CT Chest   Procedure(s): n/a   Disposition: Home   Discharge Condition: Stable
Age: 88.0
Sex: M
Vaccine: COVID19
Symptoms: Asymptomatic COVID-19, COVID-19, Death, Fall, Femur fracture
Clinical narrative: The patient with dementia, history of DVT status post IVC filter on Coumadin, hypertension fell at assisted living found to have acute left intertrochanteric hip fracture. Family requested no surgery with comfort measures only.   The patient became resident.  The patient expired at facility on 03/15/2022.   The patient did test positive for Covid-19 on 01/13/2022.  The patient was asymptomatic.
Age: 88.0
Sex: M
Vaccine: COVID19
Symptoms: SARS-CoV-2 test positive
Clinical narrative: The patient with dementia, history of DVT status post IVC filter on Coumadin, hypertension fell at assisted living found to have acute left intertrochanteric hip fracture. Family requested no surgery with comfort measures only.   The patient became resident.  The patient expired at facility on 03/15/2022.   The patient did test positive for Covid-19 on 01/13/2022.  The patient was asymptomatic.
Sex: U
Vaccine: UNK
Symptoms: COVID-19
Clinical narrative: Pt diagnosed with Covid.  Pt had Covid Vaccine.
Age: 48.0
Sex: F
Vaccine: COVID19
Symptoms: Arthralgia, Immunoglobulin therapy, Injection site pain, Pain in extremity
Clinical narrative: It started in my right upper bicep. Pain and went to excruciating pain that went up into my right shoulder. Then it went to the left shoulder and my left bicep. It started the 13th of July. It went away and then 2 weeks later it started again on the 25th the same sequence. It was worse that labor with my son. I did a tele med visit and they said IVIG was the solution; which I was already receiving.
Sex: U
Vaccine: UNK
Symptoms: COVID-19
Clinical narrative: Diagnosed with Covid.  Had the Covid Vaccine
Age: 16.0
Sex: M
Vaccine: COVID19, COVID19, COVID19
Symptoms: Blood test normal, Muscle discomfort, Musculoskeletal discomfort
Clinical narrative: My child woke up with muscle discomfort in his neck, they thought it was  it was just a muscle thang in his neck. I took him down to the ER, they did blood draw and found nothing peculiar. He went to rehab. They are now sending him to pediatric hospital to see a neurology. Next week, Wednesday, he is suppose to see a doctor and have botox put in his neck.  ER visit was at : hospital.
Age: 53.0
Sex: M
Vaccine: VARZOS
Symptoms: Syringe issue, Underdose
Clinical narrative: When injecting, needle not securely attached to barrel. Vaccine sprayed out of the barrel onto patient's arm. Patient was re-dosed as he almost certainly did not get vaccine.
Age: 45.0
Sex: U
Vaccine: SMALLMNK
Symptoms: Urticaria
Clinical narrative: No wheel noted on first attempt - 2nd attempt wheel successful
Age: 48.0
Sex: M
Vaccine: COVID19
Symptoms: Culture urine positive, Diabetic complication, Escherichia test positive, Essential hypertension, Obesity
Clinical narrative: Physician Discharge Summary     Patient: Age:50 y.o. DOB: Admit Date:  7/8/2022 Discharge Date:  7/12/2022      Principal Diagnoses:  Active Problems:   Cellulitis of groin   Type 2 diabetes mellitus with complication   OSA (obstructive sleep apnea)   Morbid obesity   Essential hypertension     Discharge Diagnosis:  Scrotal celluitis, Dm2, HTN, Morbid obesity, OSA.    Hospital Course:  The patient was admitted with the above. Urine culture grew Pansensitive E.coli. He was initally treated with rocephin and this was changed to cipro and doxycycline to complete a 10 day course. No abcess could be identified to drain. Urology folled and was to see him outpatient.    Consults to: urology.
Age: 48.0
Sex: M
Vaccine: COVID19
Symptoms: Obstructive sleep apnoea syndrome, Scrotal cellulitis, Type 2 diabetes mellitus
Clinical narrative: Physician Discharge Summary     Patient: Age:50 y.o. DOB: Admit Date:  7/8/2022 Discharge Date:  7/12/2022      Principal Diagnoses:  Active Problems:   Cellulitis of groin   Type 2 diabetes mellitus with complication   OSA (obstructive sleep apnea)   Morbid obesity   Essential hypertension     Discharge Diagnosis:  Scrotal celluitis, Dm2, HTN, Morbid obesity, OSA.    Hospital Course:  The patient was admitted with the above. Urine culture grew Pansensitive E.coli. He was initally treated with rocephin and this was changed to cipro and doxycycline to complete a 10 day course. No abcess could be identified to drain. Urology folled and was to see him outpatient.    Consults to: urology.
Age: 46.0
Sex: U
Vaccine: SMALLMNK
Symptoms: Urticaria
Clinical narrative: No wheel noted on 1st attempt/ No wheel noted on 2nd attempt. Wheel achieved on 3rd attempt by another staff member
Age: 90.0
Sex: M
Vaccine: COVID19
Symptoms: Atrial fibrillation, Blood creatinine increased, COVID-19, Chronic kidney disease, Condition aggravated
Clinical narrative: Physician discharge summary: Admit date: 7/8/2022. Discharge date: 7/12/2022. Hospital course: The patient was admitted and treated with cefepime and Flagyl. Nothing grew on cultures. Initially hypoxic, so he got steroids and remdesivir as well. He was on room air for over 24 hours (SAT 96 to 100 %), so remdesivir and steroids were stopped. He was switched to Augmentin to complete 7 days. Recommended a normal diet with thin liquids. He also had acute on chronic stage 4 CKD. Torsemide was stopped. He was given IV NS. He improved: creatine came down to 2.4 at the time of discharge. He was asked to follow-up with nephrology as an outpatient. Torsemide and Jardiance were held on discharge. Discharge condition: Fair.
Age: 90.0
Sex: M
Vaccine: COVID19
Symptoms: Culture negative, Hypoxia, Pneumonia aspiration, Type 2 diabetes mellitus
Clinical narrative: Physician discharge summary: Admit date: 7/8/2022. Discharge date: 7/12/2022. Hospital course: The patient was admitted and treated with cefepime and Flagyl. Nothing grew on cultures. Initially hypoxic, so he got steroids and remdesivir as well. He was on room air for over 24 hours (SAT 96 to 100 %), so remdesivir and steroids were stopped. He was switched to Augmentin to complete 7 days. Recommended a normal diet with thin liquids. He also had acute on chronic stage 4 CKD. Torsemide was stopped. He was given IV NS. He improved: creatine came down to 2.4 at the time of discharge. He was asked to follow-up with nephrology as an outpatient. Torsemide and Jardiance were held on discharge. Discharge condition: Fair.
Age: 75.0
Sex: F
Vaccine: COVID19
Symptoms: Incorrect dose administered, No adverse event, Wrong product administered
Clinical narrative: Our pharmacy intern incorrectly administered a fifth dose of Pfizer (12+) to patient on 8/29/2022. The patient was expecting to receive a high-dose flu vaccine. No reported adverse event as of 8/31/2022.
Age: 72.0
Sex: F
Vaccine: COVID19
Symptoms: Abdominal pain upper, Anaemia, Angiogram pulmonary normal, Anxiety disorder, Ascites
Clinical narrative: Principal Diagnoses:  Principal Problem:   Epigastric pain Active Problems:   Nausea and vomiting   Weight loss   Hypokalemia   Anxiety disorder     Discharge Diagnosis:  Acute pancreatitis Acute gastritis COVID 19 infection Hypokalemia Weight loss Anemia, mixed Debility  hypomagnesemia   Hospital Course: admitted with vomiting, weight loss, abdominal pain. CT abdomen peripancreatic fluid, thickening of duodenum. MRCP small ascites, CBD without filling defect. Tested + for COVID. IVF, NPO, and COVID treated with steroids and remdesivir. D dimer up, CTA no PE, US legs no DVT. Upper GI scope, gastritis, moderate. duodenum okay. Lower scope diverticuli, hemorrhoids. She finished COVID tx, diet advanced, pain better. At discharge pain controlled, po okay. Bowels okay. Not short of breath. ehab on discharge
Age: 72.0
Sex: F
Vaccine: COVID19
Symptoms: Asthenia, COVID-19, Computerised tomogram abdomen abnormal, Endoscopy abnormal, Fibrin D dimer increased
Clinical narrative: Principal Diagnoses:  Principal Problem:   Epigastric pain Active Problems:   Nausea and vomiting   Weight loss   Hypokalemia   Anxiety disorder     Discharge Diagnosis:  Acute pancreatitis Acute gastritis COVID 19 infection Hypokalemia Weight loss Anemia, mixed Debility  hypomagnesemia   Hospital Course: admitted with vomiting, weight loss, abdominal pain. CT abdomen peripancreatic fluid, thickening of duodenum. MRCP small ascites, CBD without filling defect. Tested + for COVID. IVF, NPO, and COVID treated with steroids and remdesivir. D dimer up, CTA no PE, US legs no DVT. Upper GI scope, gastritis, moderate. duodenum okay. Lower scope diverticuli, hemorrhoids. She finished COVID tx, diet advanced, pain better. At discharge pain controlled, po okay. Bowels okay. Not short of breath. ehab on discharge
Age: 72.0
Sex: F
Vaccine: COVID19
Symptoms: Gastritis, Haemorrhoids, Hypokalaemia, Hypomagnesaemia, Magnetic resonance cholangiopancreatography
Clinical narrative: Principal Diagnoses:  Principal Problem:   Epigastric pain Active Problems:   Nausea and vomiting   Weight loss   Hypokalemia   Anxiety disorder     Discharge Diagnosis:  Acute pancreatitis Acute gastritis COVID 19 infection Hypokalemia Weight loss Anemia, mixed Debility  hypomagnesemia   Hospital Course: admitted with vomiting, weight loss, abdominal pain. CT abdomen peripancreatic fluid, thickening of duodenum. MRCP small ascites, CBD without filling defect. Tested + for COVID. IVF, NPO, and COVID treated with steroids and remdesivir. D dimer up, CTA no PE, US legs no DVT. Upper GI scope, gastritis, moderate. duodenum okay. Lower scope diverticuli, hemorrhoids. She finished COVID tx, diet advanced, pain better. At discharge pain controlled, po okay. Bowels okay. Not short of breath. ehab on discharge
Age: 72.0
Sex: F
Vaccine: COVID19
Symptoms: Nausea, Pancreatitis acute, SARS-CoV-2 test positive, Ultrasound scan normal, Vomiting
Clinical narrative: Principal Diagnoses:  Principal Problem:   Epigastric pain Active Problems:   Nausea and vomiting   Weight loss   Hypokalemia   Anxiety disorder     Discharge Diagnosis:  Acute pancreatitis Acute gastritis COVID 19 infection Hypokalemia Weight loss Anemia, mixed Debility  hypomagnesemia   Hospital Course: admitted with vomiting, weight loss, abdominal pain. CT abdomen peripancreatic fluid, thickening of duodenum. MRCP small ascites, CBD without filling defect. Tested + for COVID. IVF, NPO, and COVID treated with steroids and remdesivir. D dimer up, CTA no PE, US legs no DVT. Upper GI scope, gastritis, moderate. duodenum okay. Lower scope diverticuli, hemorrhoids. She finished COVID tx, diet advanced, pain better. At discharge pain controlled, po okay. Bowels okay. Not short of breath. ehab on discharge
Age: 72.0
Sex: F
Vaccine: COVID19
Symptoms: Weight decreased
Clinical narrative: Principal Diagnoses:  Principal Problem:   Epigastric pain Active Problems:   Nausea and vomiting   Weight loss   Hypokalemia   Anxiety disorder     Discharge Diagnosis:  Acute pancreatitis Acute gastritis COVID 19 infection Hypokalemia Weight loss Anemia, mixed Debility  hypomagnesemia   Hospital Course: admitted with vomiting, weight loss, abdominal pain. CT abdomen peripancreatic fluid, thickening of duodenum. MRCP small ascites, CBD without filling defect. Tested + for COVID. IVF, NPO, and COVID treated with steroids and remdesivir. D dimer up, CTA no PE, US legs no DVT. Upper GI scope, gastritis, moderate. duodenum okay. Lower scope diverticuli, hemorrhoids. She finished COVID tx, diet advanced, pain better. At discharge pain controlled, po okay. Bowels okay. Not short of breath. ehab on discharge
Age: 23.0
Sex: M
Vaccine: COVID19
Symptoms: Abdominal pain upper, Anal incontinence, Haematochezia
Clinical narrative: Uncontrollable Bowel Movements, Stomach Pain, Blood in Stool
Age: 12.0
Sex: F
Vaccine: HPV9, MNQ, TDAP
Symptoms: No adverse event, Product preparation error
Clinical narrative: On August 26th at 0949 a RN went to obtain a Menveo vaccination. She noted one bottle of diluent without a powder to go with the diluent.  Staff interviewed involving the 5 previous patient administrations.  They all confirm they did not drop or break an orange vial of powder.  Unable to determine which patient received the incorrect diluent for the Menveo powder.  No adverse events.  All 5 patients are being contacted for re-vaccination of Menveo vaccine.
Age: 38.0
Sex: M
Vaccine: SMALLMNK
Symptoms: Injection site mass, Injection site pain
Clinical narrative: Patient reported receiving his first dose of Jynneos back on August 15th (will be due soon for his second dose) had been taking his maintenance every other week DUPIXENT PFS 300MG/2ML for dermatitis and reports that he injected his Dupixent a week or so before and after the vaccine dose. Patient only reports having had a sore bump at injection site but that he still has a bump there but overall his skin is fine. He gave lot number Lot FDP0018 for the vaccine.
Age: 42.0
Sex: M
Vaccine: SMALLMNK
Symptoms: Urticaria
Clinical narrative: Wheal was not formed during first try, had to repeat dose and the wheal did form.
Age: 81.0
Sex: M
Vaccine: COVID19
Symptoms: Extra dose administered
Clinical narrative: patient should not have received due to immunocompromise
Age: 36.0
Sex: M
Vaccine: COVID19
Symptoms: COVID-19, Cardiac stress test normal, Chest pain, Coronary artery disease, Diabetes mellitus
Clinical narrative: Physician Discharge Summary    37 y.o. 12/1/1984   Admit Date:  7/8/2022   Discharge Date: 7/9/22   Principal Dx/ Final Dx: Precordial pain   Relevant Inpt Dx: Principal Problem:   Precordial pain Active Problems:   Primary hypertension   Diabetes mellitus   CAD, multiple vessel       HPI:   Hospital Course:   This 37 year old man was admitted with chest pain.  He did not have MI.  He had recent normal stress test.  Echo did not show concerning abnormalities.  He was seen by cardiology and they did not plan further evaluation.  D-dimer was noraml so very unlikely PE.  He will follow up with pcp.     He did test positive for covid but no treatment needed
Age: 36.0
Sex: M
Vaccine: COVID19
Symptoms: Echocardiogram normal, Essential hypertension, Fibrin D dimer normal, SARS-CoV-2 test positive
Clinical narrative: Physician Discharge Summary    37 y.o. 12/1/1984   Admit Date:  7/8/2022   Discharge Date: 7/9/22   Principal Dx/ Final Dx: Precordial pain   Relevant Inpt Dx: Principal Problem:   Precordial pain Active Problems:   Primary hypertension   Diabetes mellitus   CAD, multiple vessel       HPI:   Hospital Course:   This 37 year old man was admitted with chest pain.  He did not have MI.  He had recent normal stress test.  Echo did not show concerning abnormalities.  He was seen by cardiology and they did not plan further evaluation.  D-dimer was noraml so very unlikely PE.  He will follow up with pcp.     He did test positive for covid but no treatment needed
Age: 47.0
Sex: F
Vaccine: COVID19
Symptoms: COVID-19, Chest X-ray normal, Chills, Cough, Fatigue
Clinical narrative: July 26th tested positive for covid, cough, sore throat, fatigue, fever, chills, malaise
Age: 47.0
Sex: F
Vaccine: COVID19
Symptoms: Influenza A virus test negative, Influenza B virus test, Malaise, Oropharyngeal pain, Pyrexia
Clinical narrative: July 26th tested positive for covid, cough, sore throat, fatigue, fever, chills, malaise
Age: 47.0
Sex: F
Vaccine: COVID19
Symptoms: SARS-CoV-2 test positive, Streptococcus test positive
Clinical narrative: July 26th tested positive for covid, cough, sore throat, fatigue, fever, chills, malaise
Age: 80.0
Sex: M
Vaccine: COVID19
Symptoms: COVID-19, SARS-CoV-2 test positive
Clinical narrative: hospitalization with covid; fully vaccinated with booster
Age: 55.0
Sex: F
Vaccine: COVID19
Symptoms: Alcohol abuse, Blood ethanol increased, COVID-19, Cerebral infarction, Cerebrovascular accident
Clinical narrative: Physician Discharge Summary   Patient ID:   56 y.o.    Admit Date:  7/8/2022   Discharge Date:   7/12/2022   Discharge Diagnosis:  Principal Problem:   CVA (cerebral vascular accident) Active Problems:   COVID-19 virus detected   Seizure   Tobacco abuse   Alcohol abuse     Hospital Course:  56 year old female with alcoholism was admitted with right side weakness while drinking a pint of whiskey. She had a seizure in the ER also. Ethanol level was 164 on arrival here. MRI head showed 10 mm infarct in the left posterior putamen extending superiorly into the corona radiata. She has been on Keppra and PT/OT. TTE showed LVH with normal EF. EEG was normal. She has been on CIWA protocol. She will be discharged home today in stable condition. Patient educated on appropriate level of care post-discharge. Follow up with neurology.   Physical Exam on the day of discharge: Last Recorded Vital Signs: Temp: 98 °F (36.7 °C) Heart Rate (Monitor): 69 Pulse: 78 BP: (!) 146/93 Respirations: 18 SpO2: 96 % General Appearance: no distress  Eyes: PERRLA ENT: moist mucus membranes, no adenopathy Lungs: clear to auscultation bilaterally  Heart: regular rate and rhythm Abdomen: soft, non-tender  Skin: No rashes or lesions  Extremities: full ROM Neuro: alert, normal strength and tone
Age: 55.0
Sex: F
Vaccine: COVID19
Symptoms: Echocardiogram abnormal, Ejection fraction normal, Electroencephalogram normal, Hemiparesis, Left ventricular hypertrophy
Clinical narrative: Physician Discharge Summary   Patient ID:   56 y.o.    Admit Date:  7/8/2022   Discharge Date:   7/12/2022   Discharge Diagnosis:  Principal Problem:   CVA (cerebral vascular accident) Active Problems:   COVID-19 virus detected   Seizure   Tobacco abuse   Alcohol abuse     Hospital Course:  56 year old female with alcoholism was admitted with right side weakness while drinking a pint of whiskey. She had a seizure in the ER also. Ethanol level was 164 on arrival here. MRI head showed 10 mm infarct in the left posterior putamen extending superiorly into the corona radiata. She has been on Keppra and PT/OT. TTE showed LVH with normal EF. EEG was normal. She has been on CIWA protocol. She will be discharged home today in stable condition. Patient educated on appropriate level of care post-discharge. Follow up with neurology.   Physical Exam on the day of discharge: Last Recorded Vital Signs: Temp: 98 °F (36.7 °C) Heart Rate (Monitor): 69 Pulse: 78 BP: (!) 146/93 Respirations: 18 SpO2: 96 % General Appearance: no distress  Eyes: PERRLA ENT: moist mucus membranes, no adenopathy Lungs: clear to auscultation bilaterally  Heart: regular rate and rhythm Abdomen: soft, non-tender  Skin: No rashes or lesions  Extremities: full ROM Neuro: alert, normal strength and tone
Age: 55.0
Sex: F
Vaccine: COVID19
Symptoms: Magnetic resonance imaging head abnormal, Seizure, Tobacco abuse
Clinical narrative: Physician Discharge Summary   Patient ID:   56 y.o.    Admit Date:  7/8/2022   Discharge Date:   7/12/2022   Discharge Diagnosis:  Principal Problem:   CVA (cerebral vascular accident) Active Problems:   COVID-19 virus detected   Seizure   Tobacco abuse   Alcohol abuse     Hospital Course:  56 year old female with alcoholism was admitted with right side weakness while drinking a pint of whiskey. She had a seizure in the ER also. Ethanol level was 164 on arrival here. MRI head showed 10 mm infarct in the left posterior putamen extending superiorly into the corona radiata. She has been on Keppra and PT/OT. TTE showed LVH with normal EF. EEG was normal. She has been on CIWA protocol. She will be discharged home today in stable condition. Patient educated on appropriate level of care post-discharge. Follow up with neurology.   Physical Exam on the day of discharge: Last Recorded Vital Signs: Temp: 98 °F (36.7 °C) Heart Rate (Monitor): 69 Pulse: 78 BP: (!) 146/93 Respirations: 18 SpO2: 96 % General Appearance: no distress  Eyes: PERRLA ENT: moist mucus membranes, no adenopathy Lungs: clear to auscultation bilaterally  Heart: regular rate and rhythm Abdomen: soft, non-tender  Skin: No rashes or lesions  Extremities: full ROM Neuro: alert, normal strength and tone
Age: 4.0
Sex: F
Vaccine: DTAPIPV, VARCEL
Symptoms: Petechiae
Clinical narrative: Diffuse petechiae around eyelids bilaterally and forehead within 15 minutes of vaccine administration.
Age: 84.0
Sex: F
Vaccine: COVID19
Symptoms: Anticoagulant therapy, Basal ganglia infarction, COVID-19, Carotid arteriosclerosis, Carotid artery stenosis
Clinical narrative: Physician Discharge Summary   Patient ID: MRN: Name:  Age: 85 y.o. Birthday:   Admit Date: 7/9/2022  4:11 PM Discharge Date:  7/18/2022 Unit: Admitting Physician:  Discharge Physician:  MD   Discharge Diagnosis: Principal Problem:   Cerebrovascular accident (CVA) due to embolism Active Problems:   COVID-19   Frequent falls   Hyponatremia   PAF (paroxysmal atrial fibrillation)       HPI:    Patient is a 85 y.o. female with PMH of CAD, AFib, HTN who presented with family d/t frequent falls.  Increasing frequency over the past two weeks, especially the last two days.  She has had some incontinence, not during falls but seems that patient knows she has to go but cannot control it.  She reports she does feel dizzy before she falls.  History is limited d/t confusion.  Incontinence does not seem to coincide with falls necessarily.  She has some shaking at rest per family but no seizure-like activity reported.   Hospital Course: No notes on file She was admitted to covid unit in airborne isolation after testting + for covid. She had mri of head that showed Right frontal infarct.  There is an infarct involving the left basal ganglia. Scattered small infarcts are seen in the subcortical white matter..she was given asa, statin. She was consulted with PT OT ST. Permissive HTN was observed. Echo showed EF of 50-55%    Carotid US showed: Greater than 69% stenosis of the left common carotid artery  2. 50-69% stenosis of the left internal carotid artery  3. No other areas of carotid arterial stenosis.  4. The vasculature demonstrates diffuse moderate atherosclerotic calcification.    She was seen by vascular surgery: Minimal carotid stenosis bilaterally. Suspect stenosis overestimated as velocities on duplex measured in cm/s on some films and m/s on others. No plans for intervention. Continue antiplatelet and statin therapy.    She has PAF. She was seen by cardiology. She was started on eliquis. After several days, she was started on antihypertensive. Xray of the right shoulder showed chronic rotator cuff tear. She is stable. She will be discharged to encompass today. Will follow up with cardiology for possible watchman.          Physical Exam on the Date of Discharge: Physical exam:  General Appearance: alert, NAD  Neck: no JVD, no LN enlargement  Lungs: clear, no wheezing   Heart: RRR, S1 S2 heard  Abdomen / GI: soft, non-tender, no ascites  Extremities / musculoskeletal:  edema, no synovitis   Skin: no rash, dry skin  Neuro: follows commands, moves extremities
Age: 84.0
Sex: F
Vaccine: COVID19
Symptoms: Cerebral infarction, Cerebrovascular accident, Confusional state, Dizziness, Echocardiogram normal
Clinical narrative: Physician Discharge Summary   Patient ID: MRN: Name:  Age: 85 y.o. Birthday:   Admit Date: 7/9/2022  4:11 PM Discharge Date:  7/18/2022 Unit: Admitting Physician:  Discharge Physician:  MD   Discharge Diagnosis: Principal Problem:   Cerebrovascular accident (CVA) due to embolism Active Problems:   COVID-19   Frequent falls   Hyponatremia   PAF (paroxysmal atrial fibrillation)       HPI:    Patient is a 85 y.o. female with PMH of CAD, AFib, HTN who presented with family d/t frequent falls.  Increasing frequency over the past two weeks, especially the last two days.  She has had some incontinence, not during falls but seems that patient knows she has to go but cannot control it.  She reports she does feel dizzy before she falls.  History is limited d/t confusion.  Incontinence does not seem to coincide with falls necessarily.  She has some shaking at rest per family but no seizure-like activity reported.   Hospital Course: No notes on file She was admitted to covid unit in airborne isolation after testting + for covid. She had mri of head that showed Right frontal infarct.  There is an infarct involving the left basal ganglia. Scattered small infarcts are seen in the subcortical white matter..she was given asa, statin. She was consulted with PT OT ST. Permissive HTN was observed. Echo showed EF of 50-55%    Carotid US showed: Greater than 69% stenosis of the left common carotid artery  2. 50-69% stenosis of the left internal carotid artery  3. No other areas of carotid arterial stenosis.  4. The vasculature demonstrates diffuse moderate atherosclerotic calcification.    She was seen by vascular surgery: Minimal carotid stenosis bilaterally. Suspect stenosis overestimated as velocities on duplex measured in cm/s on some films and m/s on others. No plans for intervention. Continue antiplatelet and statin therapy.    She has PAF. She was seen by cardiology. She was started on eliquis. After several days, she was started on antihypertensive. Xray of the right shoulder showed chronic rotator cuff tear. She is stable. She will be discharged to encompass today. Will follow up with cardiology for possible watchman.          Physical Exam on the Date of Discharge: Physical exam:  General Appearance: alert, NAD  Neck: no JVD, no LN enlargement  Lungs: clear, no wheezing   Heart: RRR, S1 S2 heard  Abdomen / GI: soft, non-tender, no ascites  Extremities / musculoskeletal:  edema, no synovitis   Skin: no rash, dry skin  Neuro: follows commands, moves extremities
Age: 84.0
Sex: F
Vaccine: COVID19
Symptoms: Ejection fraction normal, Embolism, Fall, Incontinence, Magnetic resonance imaging head abnormal
Clinical narrative: Physician Discharge Summary   Patient ID: MRN: Name:  Age: 85 y.o. Birthday:   Admit Date: 7/9/2022  4:11 PM Discharge Date:  7/18/2022 Unit: Admitting Physician:  Discharge Physician:  MD   Discharge Diagnosis: Principal Problem:   Cerebrovascular accident (CVA) due to embolism Active Problems:   COVID-19   Frequent falls   Hyponatremia   PAF (paroxysmal atrial fibrillation)       HPI:    Patient is a 85 y.o. female with PMH of CAD, AFib, HTN who presented with family d/t frequent falls.  Increasing frequency over the past two weeks, especially the last two days.  She has had some incontinence, not during falls but seems that patient knows she has to go but cannot control it.  She reports she does feel dizzy before she falls.  History is limited d/t confusion.  Incontinence does not seem to coincide with falls necessarily.  She has some shaking at rest per family but no seizure-like activity reported.   Hospital Course: No notes on file She was admitted to covid unit in airborne isolation after testting + for covid. She had mri of head that showed Right frontal infarct.  There is an infarct involving the left basal ganglia. Scattered small infarcts are seen in the subcortical white matter..she was given asa, statin. She was consulted with PT OT ST. Permissive HTN was observed. Echo showed EF of 50-55%    Carotid US showed: Greater than 69% stenosis of the left common carotid artery  2. 50-69% stenosis of the left internal carotid artery  3. No other areas of carotid arterial stenosis.  4. The vasculature demonstrates diffuse moderate atherosclerotic calcification.    She was seen by vascular surgery: Minimal carotid stenosis bilaterally. Suspect stenosis overestimated as velocities on duplex measured in cm/s on some films and m/s on others. No plans for intervention. Continue antiplatelet and statin therapy.    She has PAF. She was seen by cardiology. She was started on eliquis. After several days, she was started on antihypertensive. Xray of the right shoulder showed chronic rotator cuff tear. She is stable. She will be discharged to encompass today. Will follow up with cardiology for possible watchman.          Physical Exam on the Date of Discharge: Physical exam:  General Appearance: alert, NAD  Neck: no JVD, no LN enlargement  Lungs: clear, no wheezing   Heart: RRR, S1 S2 heard  Abdomen / GI: soft, non-tender, no ascites  Extremities / musculoskeletal:  edema, no synovitis   Skin: no rash, dry skin  Neuro: follows commands, moves extremities
Age: 84.0
Sex: F
Vaccine: COVID19
Symptoms: Oedema peripheral, Rotator cuff syndrome, SARS-CoV-2 test positive, Tremor, Ultrasound Doppler abnormal
Clinical narrative: Physician Discharge Summary   Patient ID: MRN: Name:  Age: 85 y.o. Birthday:   Admit Date: 7/9/2022  4:11 PM Discharge Date:  7/18/2022 Unit: Admitting Physician:  Discharge Physician:  MD   Discharge Diagnosis: Principal Problem:   Cerebrovascular accident (CVA) due to embolism Active Problems:   COVID-19   Frequent falls   Hyponatremia   PAF (paroxysmal atrial fibrillation)       HPI:    Patient is a 85 y.o. female with PMH of CAD, AFib, HTN who presented with family d/t frequent falls.  Increasing frequency over the past two weeks, especially the last two days.  She has had some incontinence, not during falls but seems that patient knows she has to go but cannot control it.  She reports she does feel dizzy before she falls.  History is limited d/t confusion.  Incontinence does not seem to coincide with falls necessarily.  She has some shaking at rest per family but no seizure-like activity reported.   Hospital Course: No notes on file She was admitted to covid unit in airborne isolation after testting + for covid. She had mri of head that showed Right frontal infarct.  There is an infarct involving the left basal ganglia. Scattered small infarcts are seen in the subcortical white matter..she was given asa, statin. She was consulted with PT OT ST. Permissive HTN was observed. Echo showed EF of 50-55%    Carotid US showed: Greater than 69% stenosis of the left common carotid artery  2. 50-69% stenosis of the left internal carotid artery  3. No other areas of carotid arterial stenosis.  4. The vasculature demonstrates diffuse moderate atherosclerotic calcification.    She was seen by vascular surgery: Minimal carotid stenosis bilaterally. Suspect stenosis overestimated as velocities on duplex measured in cm/s on some films and m/s on others. No plans for intervention. Continue antiplatelet and statin therapy.    She has PAF. She was seen by cardiology. She was started on eliquis. After several days, she was started on antihypertensive. Xray of the right shoulder showed chronic rotator cuff tear. She is stable. She will be discharged to encompass today. Will follow up with cardiology for possible watchman.          Physical Exam on the Date of Discharge: Physical exam:  General Appearance: alert, NAD  Neck: no JVD, no LN enlargement  Lungs: clear, no wheezing   Heart: RRR, S1 S2 heard  Abdomen / GI: soft, non-tender, no ascites  Extremities / musculoskeletal:  edema, no synovitis   Skin: no rash, dry skin  Neuro: follows commands, moves extremities
Age: 84.0
Sex: F
Vaccine: COVID19
Symptoms: X-ray limb abnormal
Clinical narrative: Physician Discharge Summary   Patient ID: MRN: Name:  Age: 85 y.o. Birthday:   Admit Date: 7/9/2022  4:11 PM Discharge Date:  7/18/2022 Unit: Admitting Physician:  Discharge Physician:  MD   Discharge Diagnosis: Principal Problem:   Cerebrovascular accident (CVA) due to embolism Active Problems:   COVID-19   Frequent falls   Hyponatremia   PAF (paroxysmal atrial fibrillation)       HPI:    Patient is a 85 y.o. female with PMH of CAD, AFib, HTN who presented with family d/t frequent falls.  Increasing frequency over the past two weeks, especially the last two days.  She has had some incontinence, not during falls but seems that patient knows she has to go but cannot control it.  She reports she does feel dizzy before she falls.  History is limited d/t confusion.  Incontinence does not seem to coincide with falls necessarily.  She has some shaking at rest per family but no seizure-like activity reported.   Hospital Course: No notes on file She was admitted to covid unit in airborne isolation after testting + for covid. She had mri of head that showed Right frontal infarct.  There is an infarct involving the left basal ganglia. Scattered small infarcts are seen in the subcortical white matter..she was given asa, statin. She was consulted with PT OT ST. Permissive HTN was observed. Echo showed EF of 50-55%    Carotid US showed: Greater than 69% stenosis of the left common carotid artery  2. 50-69% stenosis of the left internal carotid artery  3. No other areas of carotid arterial stenosis.  4. The vasculature demonstrates diffuse moderate atherosclerotic calcification.    She was seen by vascular surgery: Minimal carotid stenosis bilaterally. Suspect stenosis overestimated as velocities on duplex measured in cm/s on some films and m/s on others. No plans for intervention. Continue antiplatelet and statin therapy.    She has PAF. She was seen by cardiology. She was started on eliquis. After several days, she was started on antihypertensive. Xray of the right shoulder showed chronic rotator cuff tear. She is stable. She will be discharged to encompass today. Will follow up with cardiology for possible watchman.          Physical Exam on the Date of Discharge: Physical exam:  General Appearance: alert, NAD  Neck: no JVD, no LN enlargement  Lungs: clear, no wheezing   Heart: RRR, S1 S2 heard  Abdomen / GI: soft, non-tender, no ascites  Extremities / musculoskeletal:  edema, no synovitis   Skin: no rash, dry skin  Neuro: follows commands, moves extremities
Age: 74.0
Sex: F
Vaccine: COVID19
Symptoms: Fatigue, Malaise, Respiratory tract congestion, SARS-CoV-2 test, Throat irritation
Clinical narrative: It started with a scratchy throat, congestion, fatigue. The symptoms were mild. I also got PAXLOVID on the same day I was diagnosed. Symptoms lasted for 5 days.
Age: 24.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Chest X-ray normal, Chest pain, Dyspnoea, Headache, Hypoaesthesia
Clinical narrative: CHEST PAIN, NUMBNESS IN ARMS AND LEGS, BREATHING PROBLEMS, HEADACHES
Age: 24.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Magnetic resonance imaging head normal, Peripheral swelling
Clinical narrative: CHEST PAIN, NUMBNESS IN ARMS AND LEGS, BREATHING PROBLEMS, HEADACHES
Age: 59.0
Sex: F
Vaccine: COVID19
Symptoms: Pruritus, Rash, Urticaria
Clinical narrative: Hives, itching and rash began two days after the booster. It has been 14 weeks now ( 5/20/22 to today 8/31/22). Hives occurred daily for approximately 6 to 8 weeks. I started taking Zyrtec 10 mg onset of the rash/hives daily then every 3rd day as the rash/hives now occur every 3 to 4 days. All areas of my body including my face.   Question: Has this been reported and how long does it last? Again it has been 14 weeks now and I am still having rash/hives every 3 to 4 days and have to take Zyrtec. Thanking you in advance.
Age: 98.0
Sex: F
Vaccine: COVID19
Symptoms: Abdominal hernia, Angiogram cerebral, Angiogram pulmonary normal, Arterial occlusive disease, Arteriogram carotid
Clinical narrative: Hospital Course:  The patient was admitted with right sided weakness. She was found to have a Left parital CVA. She was also found to have COVID 19. The patient was not hypoxic and did not get treated for the Covid 19. She also had persistant afib. She was not able to swallow so she was maintained on a amiodarone gtt. She had an elevated D.dimer. CTA of the chest did not show a PE but she was found to have bilateral lower extremity DVT's. In speaking with the patient and her daughter they did not want any further testing or procedures done. The patient wanted to go home. The daughter, who is in her 70's, was not able to take care of all her needs so they decided on comforte care and wished to go to inpatient hospice. The patinet was not able to swallow her meds. I told the daughter an the pt that if we do comforte care I can let her eat but she needs to understand that her risk of aspiration is high. She voiced understanding and wished to go with comfortae care. I will let the patient eat.    Consults to:  Neurology, cardiology.    Significant Diagnostic Studies:  CT head, CTA chest, CTA head and neck. MRI brain. 2d echo.    Procedure(s): none.    Disposition:Home with hospice.    Discharge Condition:  Poor.
Age: 98.0
Sex: F
Vaccine: COVID19
Symptoms: Asthenia, Atrial fibrillation, COVID-19, Cerebrovascular accident, Computerised tomogram head
Clinical narrative: Hospital Course:  The patient was admitted with right sided weakness. She was found to have a Left parital CVA. She was also found to have COVID 19. The patient was not hypoxic and did not get treated for the Covid 19. She also had persistant afib. She was not able to swallow so she was maintained on a amiodarone gtt. She had an elevated D.dimer. CTA of the chest did not show a PE but she was found to have bilateral lower extremity DVT's. In speaking with the patient and her daughter they did not want any further testing or procedures done. The patient wanted to go home. The daughter, who is in her 70's, was not able to take care of all her needs so they decided on comforte care and wished to go to inpatient hospice. The patinet was not able to swallow her meds. I told the daughter an the pt that if we do comforte care I can let her eat but she needs to understand that her risk of aspiration is high. She voiced understanding and wished to go with comfortae care. I will let the patient eat.    Consults to:  Neurology, cardiology.    Significant Diagnostic Studies:  CT head, CTA chest, CTA head and neck. MRI brain. 2d echo.    Procedure(s): none.    Disposition:Home with hospice.    Discharge Condition:  Poor.