chrisvoncsefalvay/vaers-narrative-generation huggingface dataset:
Age: 66.0
Sex: F
Vaccine: PPV
Symptoms: Asthenia, Chills, Injection site erythema, Injection site pain, Injection site swelling
Clinical narrative: Patient reported chills, rigors, malaise, weakness, and redness surrounding injection site starting approx 24 hours after administration. Patient reported the injection site was painful, swollen, and the redness was spreading. She was seen at urgent care 11/2/22 and prescribed keflex. Redness continued to spread. She was seen in PCP office 11/4/22 and prescribed bactrim.
Age: 66.0
Sex: F
Vaccine: PPV
Symptoms: Malaise
Clinical narrative: Patient reported chills, rigors, malaise, weakness, and redness surrounding injection site starting approx 24 hours after administration. Patient reported the injection site was painful, swollen, and the redness was spreading. She was seen at urgent care 11/2/22 and prescribed keflex. Redness continued to spread. She was seen in PCP office 11/4/22 and prescribed bactrim.
Age: 54.0
Sex: M
Vaccine: COVID19
Symptoms: COVID-19, Decubitus ulcer, Pneumothorax, SARS-CoV-2 test positive
Clinical narrative: Hospitalization for left lung collapse and large decubitus ulcer (tested positive for COVID-19 upon admission) on dates 9/2/22-9/15/22.  Treated with dexamethasone, Remdesivir, vitamin C 1,000 mg PO daily, vitamin D 25 mcg PO daily, zinc 50 mg PO daily.
Age: 72.0
Sex: F
Vaccine: COVID19
Symptoms: Angiogram pulmonary abnormal, Atelectasis, COVID-19, Chest discomfort, Chronic obstructive pulmonary disease
Clinical narrative: Discharge Provider: MD  Primary Care Provider: NP    Admission Date: 10/25/2022 Discharge Date: 10/27/2022 Discharge Diagnoses:   Acute Exacerbation of COPD Chronic Hypoxic Respiratory Failure COVID-19 Hyperglycemia Dementia History of CVA Hypertension GERD Restless leg syndrome  Hospital Course: Pt is a 73 y.o. female w/ a pertinent PMHx of COPD, Dementia, and CVA  who is admitted to Hospital on 10/25/2022 for Acute exacerbation of COPD and COVID-19 infection. In the ED, she was hypoxic requiring BiPAP. She was given IV steroids in the ED along with DuoNeb. In the hospital, she was quickly weaned down to her home O2 of 2L NC. She was transitioned to PO prednisone. She continued to do well with ambulation. She was then discharged with a 12 day steroid taper and follow up with PCP
Age: 72.0
Sex: F
Vaccine: COVID19
Symptoms: Computerised tomogram thorax, Condition aggravated, Dementia, Electrocardiogram normal, Fibrin D dimer increased
Clinical narrative: Discharge Provider: MD  Primary Care Provider: NP    Admission Date: 10/25/2022 Discharge Date: 10/27/2022 Discharge Diagnoses:   Acute Exacerbation of COPD Chronic Hypoxic Respiratory Failure COVID-19 Hyperglycemia Dementia History of CVA Hypertension GERD Restless leg syndrome  Hospital Course: Pt is a 73 y.o. female w/ a pertinent PMHx of COPD, Dementia, and CVA  who is admitted to Hospital on 10/25/2022 for Acute exacerbation of COPD and COVID-19 infection. In the ED, she was hypoxic requiring BiPAP. She was given IV steroids in the ED along with DuoNeb. In the hospital, she was quickly weaned down to her home O2 of 2L NC. She was transitioned to PO prednisone. She continued to do well with ambulation. She was then discharged with a 12 day steroid taper and follow up with PCP
Age: 72.0
Sex: F
Vaccine: COVID19
Symptoms: Hyperglycaemia, Metabolic function test normal, Pneumonia, Positive airway pressure therapy, Respiratory failure
Clinical narrative: Discharge Provider: MD  Primary Care Provider: NP    Admission Date: 10/25/2022 Discharge Date: 10/27/2022 Discharge Diagnoses:   Acute Exacerbation of COPD Chronic Hypoxic Respiratory Failure COVID-19 Hyperglycemia Dementia History of CVA Hypertension GERD Restless leg syndrome  Hospital Course: Pt is a 73 y.o. female w/ a pertinent PMHx of COPD, Dementia, and CVA  who is admitted to Hospital on 10/25/2022 for Acute exacerbation of COPD and COVID-19 infection. In the ED, she was hypoxic requiring BiPAP. She was given IV steroids in the ED along with DuoNeb. In the hospital, she was quickly weaned down to her home O2 of 2L NC. She was transitioned to PO prednisone. She continued to do well with ambulation. She was then discharged with a 12 day steroid taper and follow up with PCP
Age: 72.0
Sex: F
Vaccine: COVID19
Symptoms: Troponin increased, Wheezing
Clinical narrative: Discharge Provider: MD  Primary Care Provider: NP    Admission Date: 10/25/2022 Discharge Date: 10/27/2022 Discharge Diagnoses:   Acute Exacerbation of COPD Chronic Hypoxic Respiratory Failure COVID-19 Hyperglycemia Dementia History of CVA Hypertension GERD Restless leg syndrome  Hospital Course: Pt is a 73 y.o. female w/ a pertinent PMHx of COPD, Dementia, and CVA  who is admitted to Hospital on 10/25/2022 for Acute exacerbation of COPD and COVID-19 infection. In the ED, she was hypoxic requiring BiPAP. She was given IV steroids in the ED along with DuoNeb. In the hospital, she was quickly weaned down to her home O2 of 2L NC. She was transitioned to PO prednisone. She continued to do well with ambulation. She was then discharged with a 12 day steroid taper and follow up with PCP
Age: 72.0
Sex: F
Vaccine: COVID19
Symptoms: Incorrect product formulation administered
Clinical narrative: This Covid "booster" Monovalent was given inadvertently as a booster dose to the adults instead of a bivalent dose. The label read "booster" and caused some confusion. We ordered the Bivalent dose and this primary series for 6-12/adult boosters arrived instead.The cap colors are the same. Labels look almost identical except for the boarder color. Suppose we re-label, change label colors/cap colors to prevent this from happening again?
Age: 73.0
Sex: F
Vaccine: COVID19, COVID19, COVID19
Symptoms: COVID-19, Dizziness, SARS-CoV-2 test positive
Clinical narrative: 09/08/22 presents to ED for "dizziness". PMHx of "hypertension, hyperlipidemia, diabetes with peripheral neuropathy, hypothyroidism, rheumatoid arthritis, spinal stenosis"
Age: 76.0
Sex: M
Vaccine: VARZOS
Symptoms: Arthralgia, Burning sensation, Injection site pain, Pain in extremity
Clinical narrative: 10/16/2022 reported left shoulder arm pain 8/10 and burning. Denied blisters, swelling, redness. Practitioner advised ER care.  11/03/2022 patient walked into clinic with same complaints without change.  Provider prescribed   Valacyclovir 1 gm Q8h x7 days.  Gabapentin offered and declined.
Age: 81.0
Sex: F
Vaccine: COVID19
Symptoms: COVID-19, Sepsis, Urinary tract infection
Clinical narrative: Hospitalization for Severe sepsis due to UTI, incidental COVID-19 on dates  9/7/22-9/12/22. Treated with no COVID-19 medications.
Age: 59.0
Sex: M
Vaccine: COVID19, COVID19, COVID19
Symptoms: COVID-19, SARS-CoV-2 test positive, Subcutaneous abscess
Clinical narrative: 09/08/22 presents to ED for "abscess to his back". PMHx of "diabetes, hypertension, obesity"
Age: 65.0
Sex: M
Vaccine: COVID19-2
Symptoms: Joint swelling
Clinical narrative: Swelling to knees and ankles- joints
Age: 59.0
Sex: M
Vaccine: COVID19
Symptoms: Incorrect product formulation administered
Clinical narrative: This Covid "booster" Monovalent was given inadvertently as a booster dose to the adults instead of a bivalent dose. The label read "booster" and caused some confusion. We ordered the Bivalent dose and this primary series for 6-12/adult boosters arrived instead.The cap colors are the same. Labels look almost identical except for the boarder color. Suppose we re-label, change label colors/cap colors to prevent this from happening again?
Age: 7.0
Sex: F
Vaccine: FLUC4
Symptoms: Fall, Incoherent, Malaise, Musculoskeletal stiffness, Nausea
Clinical narrative: Patient received shot in the right arm... I was giving the flu shot to the mom and other daughter when after I finished patient states that she is not feeling well. She then gets pale and non-coherent and falls back into her mother's arms and goes stiff as a board and non-responsive. She came back shortly after I went to get the pharmacist and an EMT happened to be in the lobby while we were handling it. Patient then almost puked and I asked the mom if she wanted me to call an ambulance and she responded yes. I then waiting in the vaccine room with the patient on the phone until the ambulance arrived.
Age: 7.0
Sex: F
Vaccine: FLUC4
Symptoms: Pallor, Unresponsive to stimuli
Clinical narrative: Patient received shot in the right arm... I was giving the flu shot to the mom and other daughter when after I finished patient states that she is not feeling well. She then gets pale and non-coherent and falls back into her mother's arms and goes stiff as a board and non-responsive. She came back shortly after I went to get the pharmacist and an EMT happened to be in the lobby while we were handling it. Patient then almost puked and I asked the mom if she wanted me to call an ambulance and she responded yes. I then waiting in the vaccine room with the patient on the phone until the ambulance arrived.
Age: 80.0
Sex: M
Vaccine: COVID19
Symptoms: COVID-19, Nausea, Vomiting
Clinical narrative: Hospitalization for Nausea/vomiting, incidental COVID-19 on dates 9/8/22-9/10/22.  Treated with no medications for COVID-19.
Age: 67.0
Sex: F
Vaccine: COVID19
Symptoms: Abdominal pain, COVID-19, Chest pain, Dyspnoea, SARS-CoV-2 test positive
Clinical narrative: 09/08/22 presents to EC ED for "chest pain, abdominal pain, shortness of breath". PMHx of "CVA, DM, breast ca s/p mastectomy and reconstruction, HTN, COVID, open ankle fracture s/p surgical repair"
Age: 41.0
Sex: F
Vaccine: COVID19-2
Symptoms: Medication error, Wrong product administered
Clinical narrative: Medication error.  Moderna Bivalent was given as the 1st dose in the series.  Nurse administering the injection thought the patient was requesting a booster.  She did not verify previous doses.  Patient is not exhibiting any signs or symptoms at this time.
Age: 6.0
Sex: M
Vaccine: COVID19-2
Symptoms: Fatigue
Clinical narrative: Fatigue.
Age: 78.0
Sex: M
Vaccine: COVID19
Symptoms: Incorrect product formulation administered
Clinical narrative: This Covid "booster" Monovalent was given inadvertently as a booster dose to the adults instead of a bivalent dose. The label read "booster" and caused some confusion. We ordered the Bivalent dose and this primary series for 6-12/adult boosters arrived instead.The cap colors are the same. Labels look almost identical except for the boarder color. Suppose we re-label, change label colors/cap colors to prevent this from happening again?
Age: 74.0
Sex: M
Vaccine: COVID19, COVID19, COVID19
Symptoms: Abdominal pain, COVID-19, SARS-CoV-2 test positive
Clinical narrative: 09/08/22 presents to ED for "abdominal pain". PMHx of "multiple abdominal surgeries secondary to hernia with mesh 2019, hypertension, hyperlipidemia, diabetes, COPD, asthma, GERD, renal cell cancer, gastric sleeve surgery 2016, and hemicolectomy"
Age: 84.0
Sex: M
Vaccine: COVID19
Symptoms: COVID-19, Cardiac failure, Condition aggravated
Clinical narrative: Hospitalization for heart failure exacerbation, with incidental COVID-19 on dates 9/13/22-9/16/22. Treated with vitamin C 1,000 mg PO daily, vitamin D 25 mcg PO daily, zinc 50 mg PO daily.
Age: 73.0
Sex: M
Vaccine: COVID19
Symptoms: Incorrect product formulation administered
Clinical narrative: This Covid "booster" Monovalent was given inadvertently as a booster dose to the adults instead of a bivalent dose. The label read "booster" and caused some confusion. We ordered the Bivalent dose and this primary series for 6-12/adult boosters arrived instead.The cap colors are the same. Labels look almost identical except for the boarder color. Suppose we re-label, change label colors/cap colors to prevent this from happening again?
Age: 6.0
Sex: M
Vaccine: DTAP
Symptoms: Unevaluable event
Clinical narrative: NONE AT THIS TIME        NO TREATMENT     PATIENT DOING FINE PER PARENT
Age: 72.0
Sex: F
Vaccine: COVID19-2
Symptoms: Angiogram pulmonary abnormal, Asthenia, Atrial fibrillation, COVID-19, Chest X-ray abnormal
Clinical narrative: Admission Date: 10/21/2022 Discharge Date: Nov 2, 2022 Discharge Provider: MD Primary Care Provider: MD    PRESENTING PROBLEM: Acute respiratory failure with hypoxia (HCC)   HOSPITAL COURSE: Patient is a 72 year old with COPD, tobacco / alcohol abuse, HTN, CKDIIIb, hyperparathyroidism, GERD, and distant prior partial gastrectomy due to stomach tumor.  She presented 10/21 with weeks of generalized weakness, fatigue, dyspnea, and nonproductive cough, progressive despite completing 8 of 10 days of outpatient Augmentin and 7 days of Prednisone.  CTA chest showed extensive RLL endobronchial debris and infiltrate, moderate-severe upper lobe predominant emphysema, no PE.  She was COVID-19 (+) but imaging was more concerning for aspiration pneumonia for which SLP was consulted (bedside eval showed oropharyngeal dysphagia, VFSS was unable to be completed).  Sputum from 10/22 actually grew many Serratia / PsA (antibiotics changed to Cefepime pending sensitivities).  On 10/23, she was moved to ICU with respiratory distress requiring BiPAP.  Precedex was needed due to claustrophobia.  By 10/24, she was able to wean down to nasal cannula but AM CXR showed moderate right PTX.  IR placed chest tube.  Later on 10/24, she developed rapid Atrial fib for which Amio gtt / enteral Lopressor was started.  Lopressor was titrated and she converted to NSR 10/25, amiodarone discontinued.  VFSS 10/25 showed large CP bar versus Zenker's diverticulum with associated significant esophageal retention - dysphagia diet / swallow strategies initiated.  She was transferred out of the intensive care unit and did well.  Discharge was delayed while waiting for pneumothorax to resolve and her chest tube was ultimately discontinued on 11/01.  Repeat chest x-ray today showed no recurrence of pneumothorax.  She continued to require 4 L of oxygen and the patient was discharged home.  Home oxygen was arranged.  She will continue with the prednisone taper
Age: 72.0
Sex: F
Vaccine: COVID19-2
Symptoms: Chest tube insertion, Chronic obstructive pulmonary disease, Claustrophobia, Condition aggravated, Cough
Clinical narrative: Admission Date: 10/21/2022 Discharge Date: Nov 2, 2022 Discharge Provider: MD Primary Care Provider: MD    PRESENTING PROBLEM: Acute respiratory failure with hypoxia (HCC)   HOSPITAL COURSE: Patient is a 72 year old with COPD, tobacco / alcohol abuse, HTN, CKDIIIb, hyperparathyroidism, GERD, and distant prior partial gastrectomy due to stomach tumor.  She presented 10/21 with weeks of generalized weakness, fatigue, dyspnea, and nonproductive cough, progressive despite completing 8 of 10 days of outpatient Augmentin and 7 days of Prednisone.  CTA chest showed extensive RLL endobronchial debris and infiltrate, moderate-severe upper lobe predominant emphysema, no PE.  She was COVID-19 (+) but imaging was more concerning for aspiration pneumonia for which SLP was consulted (bedside eval showed oropharyngeal dysphagia, VFSS was unable to be completed).  Sputum from 10/22 actually grew many Serratia / PsA (antibiotics changed to Cefepime pending sensitivities).  On 10/23, she was moved to ICU with respiratory distress requiring BiPAP.  Precedex was needed due to claustrophobia.  By 10/24, she was able to wean down to nasal cannula but AM CXR showed moderate right PTX.  IR placed chest tube.  Later on 10/24, she developed rapid Atrial fib for which Amio gtt / enteral Lopressor was started.  Lopressor was titrated and she converted to NSR 10/25, amiodarone discontinued.  VFSS 10/25 showed large CP bar versus Zenker's diverticulum with associated significant esophageal retention - dysphagia diet / swallow strategies initiated.  She was transferred out of the intensive care unit and did well.  Discharge was delayed while waiting for pneumothorax to resolve and her chest tube was ultimately discontinued on 11/01.  Repeat chest x-ray today showed no recurrence of pneumothorax.  She continued to require 4 L of oxygen and the patient was discharged home.  Home oxygen was arranged.  She will continue with the prednisone taper
Age: 72.0
Sex: F
Vaccine: COVID19-2
Symptoms: Dysphagia, Dyspnoea, Emphysema, Fatigue, Intensive care
Clinical narrative: Admission Date: 10/21/2022 Discharge Date: Nov 2, 2022 Discharge Provider: MD Primary Care Provider: MD    PRESENTING PROBLEM: Acute respiratory failure with hypoxia (HCC)   HOSPITAL COURSE: Patient is a 72 year old with COPD, tobacco / alcohol abuse, HTN, CKDIIIb, hyperparathyroidism, GERD, and distant prior partial gastrectomy due to stomach tumor.  She presented 10/21 with weeks of generalized weakness, fatigue, dyspnea, and nonproductive cough, progressive despite completing 8 of 10 days of outpatient Augmentin and 7 days of Prednisone.  CTA chest showed extensive RLL endobronchial debris and infiltrate, moderate-severe upper lobe predominant emphysema, no PE.  She was COVID-19 (+) but imaging was more concerning for aspiration pneumonia for which SLP was consulted (bedside eval showed oropharyngeal dysphagia, VFSS was unable to be completed).  Sputum from 10/22 actually grew many Serratia / PsA (antibiotics changed to Cefepime pending sensitivities).  On 10/23, she was moved to ICU with respiratory distress requiring BiPAP.  Precedex was needed due to claustrophobia.  By 10/24, she was able to wean down to nasal cannula but AM CXR showed moderate right PTX.  IR placed chest tube.  Later on 10/24, she developed rapid Atrial fib for which Amio gtt / enteral Lopressor was started.  Lopressor was titrated and she converted to NSR 10/25, amiodarone discontinued.  VFSS 10/25 showed large CP bar versus Zenker's diverticulum with associated significant esophageal retention - dysphagia diet / swallow strategies initiated.  She was transferred out of the intensive care unit and did well.  Discharge was delayed while waiting for pneumothorax to resolve and her chest tube was ultimately discontinued on 11/01.  Repeat chest x-ray today showed no recurrence of pneumothorax.  She continued to require 4 L of oxygen and the patient was discharged home.  Home oxygen was arranged.  She will continue with the prednisone taper
Age: 72.0
Sex: F
Vaccine: COVID19-2
Symptoms: Lung disorder, Lung infiltration, Medical diet, Oesophageal disorder, Pharyngo-oesophageal diverticulum
Clinical narrative: Admission Date: 10/21/2022 Discharge Date: Nov 2, 2022 Discharge Provider: MD Primary Care Provider: MD    PRESENTING PROBLEM: Acute respiratory failure with hypoxia (HCC)   HOSPITAL COURSE: Patient is a 72 year old with COPD, tobacco / alcohol abuse, HTN, CKDIIIb, hyperparathyroidism, GERD, and distant prior partial gastrectomy due to stomach tumor.  She presented 10/21 with weeks of generalized weakness, fatigue, dyspnea, and nonproductive cough, progressive despite completing 8 of 10 days of outpatient Augmentin and 7 days of Prednisone.  CTA chest showed extensive RLL endobronchial debris and infiltrate, moderate-severe upper lobe predominant emphysema, no PE.  She was COVID-19 (+) but imaging was more concerning for aspiration pneumonia for which SLP was consulted (bedside eval showed oropharyngeal dysphagia, VFSS was unable to be completed).  Sputum from 10/22 actually grew many Serratia / PsA (antibiotics changed to Cefepime pending sensitivities).  On 10/23, she was moved to ICU with respiratory distress requiring BiPAP.  Precedex was needed due to claustrophobia.  By 10/24, she was able to wean down to nasal cannula but AM CXR showed moderate right PTX.  IR placed chest tube.  Later on 10/24, she developed rapid Atrial fib for which Amio gtt / enteral Lopressor was started.  Lopressor was titrated and she converted to NSR 10/25, amiodarone discontinued.  VFSS 10/25 showed large CP bar versus Zenker's diverticulum with associated significant esophageal retention - dysphagia diet / swallow strategies initiated.  She was transferred out of the intensive care unit and did well.  Discharge was delayed while waiting for pneumothorax to resolve and her chest tube was ultimately discontinued on 11/01.  Repeat chest x-ray today showed no recurrence of pneumothorax.  She continued to require 4 L of oxygen and the patient was discharged home.  Home oxygen was arranged.  She will continue with the prednisone taper
Age: 72.0
Sex: F
Vaccine: COVID19-2
Symptoms: Pneumothorax, Positive airway pressure therapy, Productive cough, Respiratory distress, Respiratory symptom
Clinical narrative: Admission Date: 10/21/2022 Discharge Date: Nov 2, 2022 Discharge Provider: MD Primary Care Provider: MD    PRESENTING PROBLEM: Acute respiratory failure with hypoxia (HCC)   HOSPITAL COURSE: Patient is a 72 year old with COPD, tobacco / alcohol abuse, HTN, CKDIIIb, hyperparathyroidism, GERD, and distant prior partial gastrectomy due to stomach tumor.  She presented 10/21 with weeks of generalized weakness, fatigue, dyspnea, and nonproductive cough, progressive despite completing 8 of 10 days of outpatient Augmentin and 7 days of Prednisone.  CTA chest showed extensive RLL endobronchial debris and infiltrate, moderate-severe upper lobe predominant emphysema, no PE.  She was COVID-19 (+) but imaging was more concerning for aspiration pneumonia for which SLP was consulted (bedside eval showed oropharyngeal dysphagia, VFSS was unable to be completed).  Sputum from 10/22 actually grew many Serratia / PsA (antibiotics changed to Cefepime pending sensitivities).  On 10/23, she was moved to ICU with respiratory distress requiring BiPAP.  Precedex was needed due to claustrophobia.  By 10/24, she was able to wean down to nasal cannula but AM CXR showed moderate right PTX.  IR placed chest tube.  Later on 10/24, she developed rapid Atrial fib for which Amio gtt / enteral Lopressor was started.  Lopressor was titrated and she converted to NSR 10/25, amiodarone discontinued.  VFSS 10/25 showed large CP bar versus Zenker's diverticulum with associated significant esophageal retention - dysphagia diet / swallow strategies initiated.  She was transferred out of the intensive care unit and did well.  Discharge was delayed while waiting for pneumothorax to resolve and her chest tube was ultimately discontinued on 11/01.  Repeat chest x-ray today showed no recurrence of pneumothorax.  She continued to require 4 L of oxygen and the patient was discharged home.  Home oxygen was arranged.  She will continue with the prednisone taper
Age: 72.0
Sex: F
Vaccine: COVID19-2
Symptoms: SARS-CoV-2 test positive, Serratia test positive, Sputum culture positive, Sputum discoloured, Tachypnoea
Clinical narrative: Admission Date: 10/21/2022 Discharge Date: Nov 2, 2022 Discharge Provider: MD Primary Care Provider: MD    PRESENTING PROBLEM: Acute respiratory failure with hypoxia (HCC)   HOSPITAL COURSE: Patient is a 72 year old with COPD, tobacco / alcohol abuse, HTN, CKDIIIb, hyperparathyroidism, GERD, and distant prior partial gastrectomy due to stomach tumor.  She presented 10/21 with weeks of generalized weakness, fatigue, dyspnea, and nonproductive cough, progressive despite completing 8 of 10 days of outpatient Augmentin and 7 days of Prednisone.  CTA chest showed extensive RLL endobronchial debris and infiltrate, moderate-severe upper lobe predominant emphysema, no PE.  She was COVID-19 (+) but imaging was more concerning for aspiration pneumonia for which SLP was consulted (bedside eval showed oropharyngeal dysphagia, VFSS was unable to be completed).  Sputum from 10/22 actually grew many Serratia / PsA (antibiotics changed to Cefepime pending sensitivities).  On 10/23, she was moved to ICU with respiratory distress requiring BiPAP.  Precedex was needed due to claustrophobia.  By 10/24, she was able to wean down to nasal cannula but AM CXR showed moderate right PTX.  IR placed chest tube.  Later on 10/24, she developed rapid Atrial fib for which Amio gtt / enteral Lopressor was started.  Lopressor was titrated and she converted to NSR 10/25, amiodarone discontinued.  VFSS 10/25 showed large CP bar versus Zenker's diverticulum with associated significant esophageal retention - dysphagia diet / swallow strategies initiated.  She was transferred out of the intensive care unit and did well.  Discharge was delayed while waiting for pneumothorax to resolve and her chest tube was ultimately discontinued on 11/01.  Repeat chest x-ray today showed no recurrence of pneumothorax.  She continued to require 4 L of oxygen and the patient was discharged home.  Home oxygen was arranged.  She will continue with the prednisone taper
Age: 72.0
Sex: F
Vaccine: COVID19-2
Symptoms: Wheelchair user
Clinical narrative: Admission Date: 10/21/2022 Discharge Date: Nov 2, 2022 Discharge Provider: MD Primary Care Provider: MD    PRESENTING PROBLEM: Acute respiratory failure with hypoxia (HCC)   HOSPITAL COURSE: Patient is a 72 year old with COPD, tobacco / alcohol abuse, HTN, CKDIIIb, hyperparathyroidism, GERD, and distant prior partial gastrectomy due to stomach tumor.  She presented 10/21 with weeks of generalized weakness, fatigue, dyspnea, and nonproductive cough, progressive despite completing 8 of 10 days of outpatient Augmentin and 7 days of Prednisone.  CTA chest showed extensive RLL endobronchial debris and infiltrate, moderate-severe upper lobe predominant emphysema, no PE.  She was COVID-19 (+) but imaging was more concerning for aspiration pneumonia for which SLP was consulted (bedside eval showed oropharyngeal dysphagia, VFSS was unable to be completed).  Sputum from 10/22 actually grew many Serratia / PsA (antibiotics changed to Cefepime pending sensitivities).  On 10/23, she was moved to ICU with respiratory distress requiring BiPAP.  Precedex was needed due to claustrophobia.  By 10/24, she was able to wean down to nasal cannula but AM CXR showed moderate right PTX.  IR placed chest tube.  Later on 10/24, she developed rapid Atrial fib for which Amio gtt / enteral Lopressor was started.  Lopressor was titrated and she converted to NSR 10/25, amiodarone discontinued.  VFSS 10/25 showed large CP bar versus Zenker's diverticulum with associated significant esophageal retention - dysphagia diet / swallow strategies initiated.  She was transferred out of the intensive care unit and did well.  Discharge was delayed while waiting for pneumothorax to resolve and her chest tube was ultimately discontinued on 11/01.  Repeat chest x-ray today showed no recurrence of pneumothorax.  She continued to require 4 L of oxygen and the patient was discharged home.  Home oxygen was arranged.  She will continue with the prednisone taper
Age: 13.0
Sex: M
Vaccine: COVID19-2
Symptoms: Incorrect product formulation administered
Clinical narrative: CLIENT HAS NO PRIMARY SERIES COVID VACCINES AS STATED IN VACCINE QUESTIONAIRE. CLIENT WAS GIVEN A BIVALENT BOOSTER AS A PFIZER FIRST DOSE.
Age: 65.0
Sex: F
Vaccine: COVID19
Symptoms: Incorrect product formulation administered
Clinical narrative: This Covid "booster" Monovalent was given inadvertently as a booster dose to the adults instead of a bivalent dose. The label read "booster" and caused some confusion. We ordered the Bivalent dose and this primary series for 6-12/adult boosters arrived instead.The cap colors are the same. Labels look almost identical except for the boarder color. Suppose we re-label, change label colors/cap colors to prevent this from happening again?
Age: 70.0
Sex: M
Vaccine: COVID19
Symptoms: Incorrect product formulation administered
Clinical narrative: This Covid "booster" Monovalent was given inadvertently as a booster dose to the adults instead of a bivalent dose. The label read "booster" and caused some confusion. We ordered the Bivalent dose and this primary series for 6-12/adult boosters arrived instead.The cap colors are the same. Labels look almost identical except for the boarder color. Suppose we re-label, change label colors/cap colors to prevent this from happening again?
Age: 68.0
Sex: M
Vaccine: COVID19, COVID19, COVID19, COVID19
Symptoms: COVID-19, Chemotherapy, SARS-CoV-2 test positive
Clinical narrative: 09/08/22 presents to Hematology/Oncology for "chemo". PMHx of "Kappa light chain multiple myeloma/plasma cell leukemia"
Age: 10.0
Sex: M
Vaccine: COVID19-2
Symptoms: Injection site pain
Clinical narrative: Soreness at the injection site
Sex: U
Vaccine: COVID19-2
Symptoms: Chest discomfort, Chest pain, Dyspepsia
Clinical narrative: On 10/11, I had a sudden onset of chest pain that lasted about 30 seconds before retreating. In the weeks since then, I've had generally mild chest pain on an off. It's a slight tightness/soreness in the chest that's been very mild and lingers for a few hours at a time. Also about 2-3 times since then, I've had that same sudden onset of pain that lasts about 20-30 seconds.  There haven't been any other noticeable symptoms in the time since. The doctor put me on a 14-day treatment with Prilosec OTC. Today was my last pill and the mild pain still remains on and off. It's possible that the discomfort is caused by higher-than-usual stress and/or what I've eaten.
Age: 50.0
Sex: F
Vaccine: COVID19
Symptoms: Chest pain, Dyspnoea
Clinical narrative: chest pain, SOB
Age: 63.0
Sex: M
Vaccine: COVID19
Symptoms: Incorrect product formulation administered
Clinical narrative: This Covid "booster" Monovalent was given inadvertently as a booster dose to the adults instead of a bivalent dose. The label read "booster" and caused some confusion. We ordered the Bivalent dose and this primary series for 6-12/adult boosters arrived instead.The cap colors are the same. Labels look almost identical except for the boarder color. Suppose we re-label, change label colors/cap colors to prevent this from happening again?
Age: 44.0
Sex: F
Vaccine: COVID19-2, FLUC4
Symptoms: Erythema, Lymphadenopathy, Rash, Rash erythematous, Rash papular
Clinical narrative: Started  on 10/11/2022, the patient had swollen lymph nodes under and in front of the right ear with a rash inside the ear and across the cheekbone. Over the next several days, the lymph nodes continued to swell, the rash became red with papule like structures on the face and in the ear with a yellow/white center. Under the right eye swelled and became red as well. Most of the swelling has since decreased except the lymph node under the right ear. The papule like structures have become raised dark scabs (one in ear and two on the cheekbone- one was quite large the other medium size) at time of interview on October 26th at 2 pm.
Age: 44.0
Sex: F
Vaccine: COVID19-2, FLUC4
Symptoms: Scab, Swelling face
Clinical narrative: Started  on 10/11/2022, the patient had swollen lymph nodes under and in front of the right ear with a rash inside the ear and across the cheekbone. Over the next several days, the lymph nodes continued to swell, the rash became red with papule like structures on the face and in the ear with a yellow/white center. Under the right eye swelled and became red as well. Most of the swelling has since decreased except the lymph node under the right ear. The papule like structures have become raised dark scabs (one in ear and two on the cheekbone- one was quite large the other medium size) at time of interview on October 26th at 2 pm.
Age: 67.0
Sex: F
Vaccine: COVID19
Symptoms: Incorrect product formulation administered
Clinical narrative: This Covid "booster" Monovalent was given inadvertently as a booster dose to the adults instead of a bivalent dose. The label read "booster" and caused some confusion. We ordered the Bivalent dose and this primary series for 6-12/adult boosters arrived instead.The cap colors are the same. Labels look almost identical except for the boarder color. Suppose we re-label, change label colors/cap colors to prevent this from happening again?
Age: 1.0
Sex: M
Vaccine: VARCEL
Symptoms: Varicella
Clinical narrative: Pt received 2 doses of varicella vaccine- 1/23/2012 and 8/11/2016 (Proquad- L032761) and was then diagnosed with chickenpox on 11/1/2022
Age: 72.0
Sex: M
Vaccine: COVID19
Symptoms: Incorrect product formulation administered
Clinical narrative: This Covid "booster" Monovalent was given inadvertently as a booster dose to the adults instead of a bivalent dose. The label read "booster" and caused some confusion. We ordered the Bivalent dose and this primary series for 6-12/adult boosters arrived instead.The cap colors are the same. Labels look almost identical except for the boarder color. Suppose we re-label, change label colors/cap colors to prevent this from happening again?
Age: 10.0
Sex: F
Vaccine: COVID19-2
Symptoms: Injection site pain
Clinical narrative: Soreness at injection site
Age: 87.0
Sex: M
Vaccine: COVID19
Symptoms: Asthenia, Atrial fibrillation, Bundle branch block left, COVID-19, Cardiac failure chronic
Clinical narrative: COVID+ 10/27/2022 BRIEF OVERVIEW: Discharge Provider: DO Primary Care Provider: DO Admission Date: 10/25/2022 Discharge Date: Nov 2, 2022   Active Hospital Problems   Diagnosis Date Noted POA ? Dilated cardiomyopathy  05/02/2022 Yes ? Chronic combined systolic and diastolic heart failure  04/08/2022 Yes ? Nephrostomy status  03/22/2022 Yes ? Lymphoma  03/22/2022 Yes ? Hydronephrosis 03/17/2022 Yes ? Type 2 diabetes mellitus with diabetic neuropathy  03/14/2022 Yes ? Retroperitoneal mass 03/14/2022 Yes ? Chronic kidney disease (CKD), stage IV (severe)  03/14/2022 Yes ? Paroxysmal atrial fibrillation  03/14/2022 Yes ? Subclinical hypothyroidism 03/12/2021 Yes ? Thoracic aortic aneurysm without rupture 05/22/2020 Yes ? Lymphadenopathy, retroperitoneal 04/21/2020 Yes ? At risk for falls 06/13/2017 Yes ? Persistent proteinuria associated with type 2 diabetes mellitus   03/22/2016 Yes ? History of prostate cancer 02/22/2012 Yes ? Hypertension 07/06/2010 Yes ? Type 2 diabetes 07/06/2010 Yes  DETAILS OF HOSPITAL STAY: PRESENTING PROBLEM: COVID-19 virus infection [U07.1]   HOSPITAL COURSE: Patient is a 88 y.o. male with past medical history significant for CHFrEF (now 20%), PAF on Eliquis, HTN, CKD4, DM2, hydronephrosis status post right nephrostomy, who present to emergency department with a complaint of weakness and fall.  Patient developed generalized weakness, cold symptoms, and malaise and had a ground level fall after receiving his COVID-19 and flu vaccine.   Upon arrival at emergency department patient's vitals blood pressure 123/60, pulse 114, temperature 97.7°, O2 sat 98% on room air, respiration 18. Imaging CT of the head and cervical spine showed no acute intracranial process or fracture.  Chest x-ray showed mild left pleural effusion without evidence of infiltrate or opacity. EKG showed atrial fibrillation with heart rate at 117, as well as left anterior fascicular block.  Given patient's frequent fall and generalized weakness as well as COVID-19 infection that patient tested positive for, patient was admitted to general medicine for further management and PT OT and case manager will be consulted for placement.   Due to frequent falls patients eliquis was discontinued. Patient and son both agreed on this. Repeat ECHO did note decrease in EF from 40 to 21%. Patient was continued on his goal directed medical therapy of Toprol XL and lisinopril. No evidence of acute CHF. Recommend to follow up with Cardiology outpatient for repeat ECHO and optimization of medical therapy. This was communicated to his son who voiced understanding.    Orthopedics was consulted for mildly displaced R fibular fracture during his stay for which orthopedic surgery recommended conservative management with weight-bearing as tolerated. Outpatient ortho follow up in 1 week.   Patient discharged back to assisted living in stable condition. Discharge instructions reviewed with son over the phone.
Age: 87.0
Sex: M
Vaccine: COVID19
Symptoms: Chest X-ray abnormal, Chronic kidney disease, Computerised tomogram head normal, Computerised tomogram spine, Congestive cardiomyopathy
Clinical narrative: COVID+ 10/27/2022 BRIEF OVERVIEW: Discharge Provider: DO Primary Care Provider: DO Admission Date: 10/25/2022 Discharge Date: Nov 2, 2022   Active Hospital Problems   Diagnosis Date Noted POA ? Dilated cardiomyopathy  05/02/2022 Yes ? Chronic combined systolic and diastolic heart failure  04/08/2022 Yes ? Nephrostomy status  03/22/2022 Yes ? Lymphoma  03/22/2022 Yes ? Hydronephrosis 03/17/2022 Yes ? Type 2 diabetes mellitus with diabetic neuropathy  03/14/2022 Yes ? Retroperitoneal mass 03/14/2022 Yes ? Chronic kidney disease (CKD), stage IV (severe)  03/14/2022 Yes ? Paroxysmal atrial fibrillation  03/14/2022 Yes ? Subclinical hypothyroidism 03/12/2021 Yes ? Thoracic aortic aneurysm without rupture 05/22/2020 Yes ? Lymphadenopathy, retroperitoneal 04/21/2020 Yes ? At risk for falls 06/13/2017 Yes ? Persistent proteinuria associated with type 2 diabetes mellitus   03/22/2016 Yes ? History of prostate cancer 02/22/2012 Yes ? Hypertension 07/06/2010 Yes ? Type 2 diabetes 07/06/2010 Yes  DETAILS OF HOSPITAL STAY: PRESENTING PROBLEM: COVID-19 virus infection [U07.1]   HOSPITAL COURSE: Patient is a 88 y.o. male with past medical history significant for CHFrEF (now 20%), PAF on Eliquis, HTN, CKD4, DM2, hydronephrosis status post right nephrostomy, who present to emergency department with a complaint of weakness and fall.  Patient developed generalized weakness, cold symptoms, and malaise and had a ground level fall after receiving his COVID-19 and flu vaccine.   Upon arrival at emergency department patient's vitals blood pressure 123/60, pulse 114, temperature 97.7°, O2 sat 98% on room air, respiration 18. Imaging CT of the head and cervical spine showed no acute intracranial process or fracture.  Chest x-ray showed mild left pleural effusion without evidence of infiltrate or opacity. EKG showed atrial fibrillation with heart rate at 117, as well as left anterior fascicular block.  Given patient's frequent fall and generalized weakness as well as COVID-19 infection that patient tested positive for, patient was admitted to general medicine for further management and PT OT and case manager will be consulted for placement.   Due to frequent falls patients eliquis was discontinued. Patient and son both agreed on this. Repeat ECHO did note decrease in EF from 40 to 21%. Patient was continued on his goal directed medical therapy of Toprol XL and lisinopril. No evidence of acute CHF. Recommend to follow up with Cardiology outpatient for repeat ECHO and optimization of medical therapy. This was communicated to his son who voiced understanding.    Orthopedics was consulted for mildly displaced R fibular fracture during his stay for which orthopedic surgery recommended conservative management with weight-bearing as tolerated. Outpatient ortho follow up in 1 week.   Patient discharged back to assisted living in stable condition. Discharge instructions reviewed with son over the phone.
Age: 87.0
Sex: M
Vaccine: COVID19
Symptoms: Diabetic neuropathy, Echocardiogram abnormal, Ejection fraction decreased, Electrocardiogram abnormal, Fall
Clinical narrative: COVID+ 10/27/2022 BRIEF OVERVIEW: Discharge Provider: DO Primary Care Provider: DO Admission Date: 10/25/2022 Discharge Date: Nov 2, 2022   Active Hospital Problems   Diagnosis Date Noted POA ? Dilated cardiomyopathy  05/02/2022 Yes ? Chronic combined systolic and diastolic heart failure  04/08/2022 Yes ? Nephrostomy status  03/22/2022 Yes ? Lymphoma  03/22/2022 Yes ? Hydronephrosis 03/17/2022 Yes ? Type 2 diabetes mellitus with diabetic neuropathy  03/14/2022 Yes ? Retroperitoneal mass 03/14/2022 Yes ? Chronic kidney disease (CKD), stage IV (severe)  03/14/2022 Yes ? Paroxysmal atrial fibrillation  03/14/2022 Yes ? Subclinical hypothyroidism 03/12/2021 Yes ? Thoracic aortic aneurysm without rupture 05/22/2020 Yes ? Lymphadenopathy, retroperitoneal 04/21/2020 Yes ? At risk for falls 06/13/2017 Yes ? Persistent proteinuria associated with type 2 diabetes mellitus   03/22/2016 Yes ? History of prostate cancer 02/22/2012 Yes ? Hypertension 07/06/2010 Yes ? Type 2 diabetes 07/06/2010 Yes  DETAILS OF HOSPITAL STAY: PRESENTING PROBLEM: COVID-19 virus infection [U07.1]   HOSPITAL COURSE: Patient is a 88 y.o. male with past medical history significant for CHFrEF (now 20%), PAF on Eliquis, HTN, CKD4, DM2, hydronephrosis status post right nephrostomy, who present to emergency department with a complaint of weakness and fall.  Patient developed generalized weakness, cold symptoms, and malaise and had a ground level fall after receiving his COVID-19 and flu vaccine.   Upon arrival at emergency department patient's vitals blood pressure 123/60, pulse 114, temperature 97.7°, O2 sat 98% on room air, respiration 18. Imaging CT of the head and cervical spine showed no acute intracranial process or fracture.  Chest x-ray showed mild left pleural effusion without evidence of infiltrate or opacity. EKG showed atrial fibrillation with heart rate at 117, as well as left anterior fascicular block.  Given patient's frequent fall and generalized weakness as well as COVID-19 infection that patient tested positive for, patient was admitted to general medicine for further management and PT OT and case manager will be consulted for placement.   Due to frequent falls patients eliquis was discontinued. Patient and son both agreed on this. Repeat ECHO did note decrease in EF from 40 to 21%. Patient was continued on his goal directed medical therapy of Toprol XL and lisinopril. No evidence of acute CHF. Recommend to follow up with Cardiology outpatient for repeat ECHO and optimization of medical therapy. This was communicated to his son who voiced understanding.    Orthopedics was consulted for mildly displaced R fibular fracture during his stay for which orthopedic surgery recommended conservative management with weight-bearing as tolerated. Outpatient ortho follow up in 1 week.   Patient discharged back to assisted living in stable condition. Discharge instructions reviewed with son over the phone.
Age: 87.0
Sex: M
Vaccine: COVID19
Symptoms: Fibula fracture, Hydronephrosis, Left ventricular failure, Lymphoma, Malaise
Clinical narrative: COVID+ 10/27/2022 BRIEF OVERVIEW: Discharge Provider: DO Primary Care Provider: DO Admission Date: 10/25/2022 Discharge Date: Nov 2, 2022   Active Hospital Problems   Diagnosis Date Noted POA ? Dilated cardiomyopathy  05/02/2022 Yes ? Chronic combined systolic and diastolic heart failure  04/08/2022 Yes ? Nephrostomy status  03/22/2022 Yes ? Lymphoma  03/22/2022 Yes ? Hydronephrosis 03/17/2022 Yes ? Type 2 diabetes mellitus with diabetic neuropathy  03/14/2022 Yes ? Retroperitoneal mass 03/14/2022 Yes ? Chronic kidney disease (CKD), stage IV (severe)  03/14/2022 Yes ? Paroxysmal atrial fibrillation  03/14/2022 Yes ? Subclinical hypothyroidism 03/12/2021 Yes ? Thoracic aortic aneurysm without rupture 05/22/2020 Yes ? Lymphadenopathy, retroperitoneal 04/21/2020 Yes ? At risk for falls 06/13/2017 Yes ? Persistent proteinuria associated with type 2 diabetes mellitus   03/22/2016 Yes ? History of prostate cancer 02/22/2012 Yes ? Hypertension 07/06/2010 Yes ? Type 2 diabetes 07/06/2010 Yes  DETAILS OF HOSPITAL STAY: PRESENTING PROBLEM: COVID-19 virus infection [U07.1]   HOSPITAL COURSE: Patient is a 88 y.o. male with past medical history significant for CHFrEF (now 20%), PAF on Eliquis, HTN, CKD4, DM2, hydronephrosis status post right nephrostomy, who present to emergency department with a complaint of weakness and fall.  Patient developed generalized weakness, cold symptoms, and malaise and had a ground level fall after receiving his COVID-19 and flu vaccine.   Upon arrival at emergency department patient's vitals blood pressure 123/60, pulse 114, temperature 97.7°, O2 sat 98% on room air, respiration 18. Imaging CT of the head and cervical spine showed no acute intracranial process or fracture.  Chest x-ray showed mild left pleural effusion without evidence of infiltrate or opacity. EKG showed atrial fibrillation with heart rate at 117, as well as left anterior fascicular block.  Given patient's frequent fall and generalized weakness as well as COVID-19 infection that patient tested positive for, patient was admitted to general medicine for further management and PT OT and case manager will be consulted for placement.   Due to frequent falls patients eliquis was discontinued. Patient and son both agreed on this. Repeat ECHO did note decrease in EF from 40 to 21%. Patient was continued on his goal directed medical therapy of Toprol XL and lisinopril. No evidence of acute CHF. Recommend to follow up with Cardiology outpatient for repeat ECHO and optimization of medical therapy. This was communicated to his son who voiced understanding.    Orthopedics was consulted for mildly displaced R fibular fracture during his stay for which orthopedic surgery recommended conservative management with weight-bearing as tolerated. Outpatient ortho follow up in 1 week.   Patient discharged back to assisted living in stable condition. Discharge instructions reviewed with son over the phone.
Age: 87.0
Sex: M
Vaccine: COVID19
Symptoms: Nasopharyngitis, Nephrostomy, Pleural effusion, Retroperitoneal mass, SARS-CoV-2 test positive
Clinical narrative: COVID+ 10/27/2022 BRIEF OVERVIEW: Discharge Provider: DO Primary Care Provider: DO Admission Date: 10/25/2022 Discharge Date: Nov 2, 2022   Active Hospital Problems   Diagnosis Date Noted POA ? Dilated cardiomyopathy  05/02/2022 Yes ? Chronic combined systolic and diastolic heart failure  04/08/2022 Yes ? Nephrostomy status  03/22/2022 Yes ? Lymphoma  03/22/2022 Yes ? Hydronephrosis 03/17/2022 Yes ? Type 2 diabetes mellitus with diabetic neuropathy  03/14/2022 Yes ? Retroperitoneal mass 03/14/2022 Yes ? Chronic kidney disease (CKD), stage IV (severe)  03/14/2022 Yes ? Paroxysmal atrial fibrillation  03/14/2022 Yes ? Subclinical hypothyroidism 03/12/2021 Yes ? Thoracic aortic aneurysm without rupture 05/22/2020 Yes ? Lymphadenopathy, retroperitoneal 04/21/2020 Yes ? At risk for falls 06/13/2017 Yes ? Persistent proteinuria associated with type 2 diabetes mellitus   03/22/2016 Yes ? History of prostate cancer 02/22/2012 Yes ? Hypertension 07/06/2010 Yes ? Type 2 diabetes 07/06/2010 Yes  DETAILS OF HOSPITAL STAY: PRESENTING PROBLEM: COVID-19 virus infection [U07.1]   HOSPITAL COURSE: Patient is a 88 y.o. male with past medical history significant for CHFrEF (now 20%), PAF on Eliquis, HTN, CKD4, DM2, hydronephrosis status post right nephrostomy, who present to emergency department with a complaint of weakness and fall.  Patient developed generalized weakness, cold symptoms, and malaise and had a ground level fall after receiving his COVID-19 and flu vaccine.   Upon arrival at emergency department patient's vitals blood pressure 123/60, pulse 114, temperature 97.7°, O2 sat 98% on room air, respiration 18. Imaging CT of the head and cervical spine showed no acute intracranial process or fracture.  Chest x-ray showed mild left pleural effusion without evidence of infiltrate or opacity. EKG showed atrial fibrillation with heart rate at 117, as well as left anterior fascicular block.  Given patient's frequent fall and generalized weakness as well as COVID-19 infection that patient tested positive for, patient was admitted to general medicine for further management and PT OT and case manager will be consulted for placement.   Due to frequent falls patients eliquis was discontinued. Patient and son both agreed on this. Repeat ECHO did note decrease in EF from 40 to 21%. Patient was continued on his goal directed medical therapy of Toprol XL and lisinopril. No evidence of acute CHF. Recommend to follow up with Cardiology outpatient for repeat ECHO and optimization of medical therapy. This was communicated to his son who voiced understanding.    Orthopedics was consulted for mildly displaced R fibular fracture during his stay for which orthopedic surgery recommended conservative management with weight-bearing as tolerated. Outpatient ortho follow up in 1 week.   Patient discharged back to assisted living in stable condition. Discharge instructions reviewed with son over the phone.